How to Cut Your Breast Cancer Risk at Any Age: A Decade-by-Decade Guide

woman-breast-cancer
A womans chance of being diagnosed with breast cancer is about 1 in 233 when she's in her 30s and rises to 1 in 8 by the time shes reached 85.
(ISTOCKPHOTO)
Breast cancer research offers more and more evidence that you can influence your own breast cancer future by picking up some good habits—and your age says a lot about which habits are key.

The following decade-by-decade guide suggests a few steps that every woman can take to protect her breast health, with extra emphasis on monitoring any changes so that problems can be caught early, when cancer is easier to treat.

Heres what you can do to cut your breast cancer risk if youre in your...

20s

30s

40s

50s

60s or older

red-wine-glass
Alcohol use increases your risk for breast cancer. Try to limit yourself to no more than one drink per day.
(ISTOCKPHOTO)
IF YOU'RE IN YOUR 20s...

Most twentysomethings are too busy finishing school, launching careers, and starting families to consider their risk of breast cancer. And it is relatively rare: The probability of a woman in her 20s developing the disease is only 1 in 1,837. But your 20s are the ideal time to start reducing your risk of getting the disease in the future. Heres what you can do.

1. Get a clinical breast exam.
These tests involve a physical exam by a medical professional and should be repeated at least every three years during your 20s.

2. Be breast aware.
Though some doctors now consider breast self-exams optional, its a smart idea to become familiar with your breasts so you notice any small changes, which you should then bring to the attention of your doctor ASAP.

Learn how to check your breasts and read the stories of three women who found their own breast cancer.

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3. Find out if youre at high risk.
If breast cancer runs in your family, talk to your doctor about whether you need stepped up screening.

“For a small subgroup of women with strong family histories of breast cancer, we recommend starting screening, including annual mammograms and MRIs, at age 25,” says Julie R. Gralow, MD, the director of breast medical oncology at the University of Washington and Fred Hutchinson Cancer Research Center in Seattle.

You may also want to consider getting tested for the BRCA-1 and BRCA-2 gene mutations, which are linked to an increased risk of breast cancer.

4. Drink less alcohol.
“This means no more than one drink per day,” says Anne McTiernan, MD, PhD, the director of the Prevention Center at the Fred Hutchinson Cancer Research Center in Seattle and coauthor with Dr. Gralow of Breast Fitness: An Optimal Exercise and Health Plan for Reducing Your Risk of Breast Cancer. “Alcohol use increases your risk for breast cancer.” Sadly, this doesnt mean you can “save up” a weeks worth of drinks for a big Saturday night on the town.

5. If you have children, breast-feed them for at least six months.
Some studies suggest that breast-feeding may slightly lower breast cancer risk, particularly if a woman continues breast feeding for one and a half to two years. A recent study by researchers at the Fred Hutchinson Cancer Research Center showed that breast feeding for six months or longer reduced the risk of low grade, slow-growing breast cancer by 20%, while the risk of triple-negative disease was cut by 50%.

6. Stay active.
Studies suggest that exercising three to four hours per week at moderate or vigorous levels can reduce your risk of breast cancer by about 20%. Whether it's brisk walking, biking, dancing, or jogging, work to keep your heart rate above its baseline level for at least 20 minutes at a time.

7. Eat a healthy diet.
While the relationship between diet and cancer is far from established, research suggests that a plant-based diet is associated with reduced risks for several cancers. The National Cancer Institute has for many years recommended that members of the general population eat at least five servings of fruits and vegetables per day, but Dr. McTiernan points out that most experts on cancer and diet recommend at least double that amount. Focus especially on eating a variety of brightly colored vegetables and fruits, as these contain the highest concentrations of vitamins.

Limit your intake of red meat to 4 ounces (about the size of a deck of cards) per day on average. Dr. McTiernan also recommends avoiding meats such as sausages and bologna. “The chemicals that are used to process the meats have been found to cause several kinds of cancers,” she notes. Strive also to minimize your intake of high-calorie foods such as sugary drinks, juice, desserts, and candies, as well as refined breads and chips.

woman-breastfeeding-daughter
A recent study showed that breast feeding for six months or longer reduced the risk of low grade, slow-growing breast cancer by 20%.
(ISTOCKPHOTO)
IF YOU'RE IN YOUR 30s...

Breast cancer rates for women in their 30s are still relatively low, but this is the time to get serious about monitoring your breasts for any changes. Heres some good breast-healthy behavior to cultivate during this decade.

1. Get a clinical breast exam every three years.
Also monitor your own breasts, and if you notice any changes, alert your doctor. If youre at high risk due to a close family history, your doctor may want you to start getting annual mammograms and MRIs as well.

2. Drink less alcohol.
“This means no more than one drink per day,” says Anne McTiernan, MD, PhD, the director of the Prevention Center at the Fred Hutchinson Cancer Research Center in Seattle and coauthor of Breast Fitness: An Optimal Exercise and Health Plan for Reducing Your Risk of Breast Cancer. “Alcohol use increases your risk for breast cancer.” Sadly, this doesnt mean you can “save up” a weeks worth of drinks for a big Saturday night on the town.

3. If you have children, breast-feed them for at least six months.
Some studies suggest that breast-feeding may slightly lower breast cancer risk, particularly if a woman continues breast feeding for one and a half to two years. A recent study by researchers at the Fred Hutchinson Cancer Research Center showed that breast feeding for six months or longer reduced the risk of low grade, slow-growing breast cancer by 20%, while the risk of triple-negative disease was cut by 50%.

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4. Avoid eating too much red and processed meat.
Limit your intake of red meat to 4 ounces (about the size of a deck of cards) per day on average, says Dr. McTiernan. She also recommends avoiding meats such as sausages and bologna. “The chemicals that are used to process the meats have been found to cause several kinds of cancers,” she notes.

Strive also to eat 10 servings of fruits and vegetables a day and minimize your intake of high-calorie foods such as sugary drinks, juice, desserts, and candies, as well as refined breads and chips.

5. If youre at high risk of getting breast cancer, ask your doctor whether youre a good candidate for chemoprevention.
Tamoxifen is approved for use in premenopausal women at high risk of developing breast cancer. “While the average woman should not take a drug to reduce the risk of breast cancer," explains Julie R. Gralow, MD, the director of breast medical oncology at the University of Washington and Fred Hutchinson Cancer Research Center in Seattle, "I would consider them for a woman whos had a biopsy that shows an increased risk for development of cancer."

6. Stay active.
Studies suggest that exercising three to four hours per week at moderate or vigorous levels can reduce your risk of breast cancer by about 20%. Whether it's brisk walking, biking, dancing, or jogging, work to keep your heart rate above its baseline level for at least 20 minutes at a time.

MORE TO CONSIDER:

Can stressful life events increase your risk of breast cancer?
The relationship between attitude, outlook, mood, and breast cancer is up for debate, but a recent Israeli study of women under the age of 45 found that exposure to several stressful life events, such as the divorce or death of parents before 20 years of age, was associated with breast cancer. “Experiencing more than one [negative] meaningful life event...is a risk factor for breast cancer among young women,” the authors, from Ben-Gurion University of the Negev in Beer Sheva and Haifa University in Haifa, Israel, wrote. “On the other hand, general feelings of happiness and optimism can play a protective role against the disease.”

Sounds simple enough: Don't worry, be happy, avoid breast cancer. But Ronit Peled, PhD, MPH, the lead author of the study and an epidemiologist at Ben-Gurion University of the Negev, notes that simply being optimistic and having positive feelings are not enough to prevent breast cancer. But happiness and optimism, she adds, along with positive lifestyle factors including diet and exercise, cumulatively contribute to good health.

The findings come with a few more caveats. As a retrospective study, the subjects were interviewed after their breast cancer diagnoses, which means that the disease may have impacted the overall evaluations of their lives retroactively. And some in the medical community are concerned with the message that women may gather from this sort of research.

"Nobody can control these kinds of stresses," says Julia A. Smith, MD, the director of the NYU Cancer Institute's breast cancer screening and prevention program and director of the Lynne Cohen breast cancer preventive care program at NYU in New York City. "And I don't think it's a good idea to present to women evidence that says if they're not happy or if they're stressed out, they might be causing their cancer." What's more, says Dr. Smith, there's evidence that shows the opposite of the Israeli study's findings may be true, that stress may actually be an immune system catalyst that might lower one's risk for the disease. In any event, more research is needed to pin down any links between attitude, mood, stress, and breast cancer before any conclusions are drawn.

Until then, Dr. McTiernan advises women who've experienced stressful life events to do what she'd advise for anyone, regardless of cancer risk: "Seek counseling from a support group, counselor, or clergy to help deal with the event and surrounding stress and grief, which should help with overall health."

five-green-apples
Most experts on cancer and diet recommend at least 10 servings of fruits and vegetables per day.
(ISTOCKPHOTO)
IF YOU'RE IN YOUR 40s...

Women in their 40s need to be more vigilant than ever about their breast screening as cancer rates start to increase at this time of life: The probability of a woman in her 40s developing the disease is 1 in 70. Implementing healthy habits such as these becomes even more important.

1. Schedule an annual mammogram and clinical exam, and check your own breasts.
The American Cancer Society recommends that women age 40 and older get a mammogram and a clinical breast exam every year. Also, stay familiar with your own breasts: If you notice any changes, tell your doctor about them immediately. Chances are good that any changes you notice, such as fibrocystic breast changes, are harmless, but it's still essential to have anything new or unusual checked out.

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2. Drink less alcohol.
“This means no more than one drink per day,” says Anne McTiernan, MD, PhD, the director of the Prevention Center at the Fred Hutchinson Cancer Research Center in Seattle and coauthor of Breast Fitness: An Optimal Exercise and Health Plan for Reducing Your Risk of Breast Cancer. “Alcohol use increases your risk for breast cancer.” Sadly, this doesnt mean you can “save up” a weeks worth of drinks for a big Saturday night on the town.

3. Eat a healthy diet.
Dr. McTiernan points out that while the relationship between diet and cancer is far from established, research suggests that a plant-based diet is associated with reduced risks for several cancers. The National Cancer Institute has for many years recommended that members of the general population eat at least five servings of fruits and vegetables per day, but Dr. McTiernan points out that most experts on cancer and diet recommend at least double that amount. Focus especially on eating a variety of brightly colored vegetables and fruits, as these contain the highest concentrations of vitamins.

Limit your intake of red meat to 4 ounces (about the size of a deck of cards) per day on average. Dr. McTiernan also recommends avoiding meats such as sausages and bologna. “The chemicals that are used to process the meats have been found to cause several kinds of cancers,” she notes. Strive also to minimize your intake of high-calorie foods such as sugary drinks, juice, desserts, and candies, as well as refined breads and chips.

4. Stay active.
Studies suggest that exercising three to four hours per week at moderate or vigorous levels can reduce your risk of breast cancer by about 20%. “We found in the Womens Health Initiative that there was a benefit to exercising in middle to late years even in women who were inactive when young,” says Dr. McTiernan.

And you dont have to be Dara Torres to reap the benefits: Activities like brisk walking, biking, dancing, or any exercise that raises your heart rate above its baseline level for at least 20 minutes and makes you sweat are beneficial.

5. Consider chemoprevention.
If youre at high risk of getting breast cancer, ask your doctor whether youre a good candidate for chemoprevention. Tamoxifen is approved for use in premenopausal women at high risk of developing breast cancer. “While the average woman should not take a drug to reduce the risk of breast cancer," explains Julie R. Gralow, MD, the director of breast medical oncology at the University of Washington and Fred Hutchinson Cancer Research Center in Seattle, "I would consider them for a woman whos had a biopsy that shows an increased risk for development of cancer."


MORE TO CONSIDER:

Avoid unnecessary exposure to cancer-causing substances.
Radiation and some chemicals are known to cause cancer, says Dr. McTiernan. “Make sure that any physician who orders an X-ray for you, especially high dose ones like CT scans, knows how many previous X-rays you have had,” advises Dr. McTiernan. “If it is not an emergency situation, ask if there is an alternative examination that would suit your situation, such as an ultrasound or MRI, neither of which involves radiation." (Your doctor can help you weigh the relative risk of momentary exposure to radiation versus not having an X-ray or CT scan that may be medically necessary.)

“Also,” adds Dr. McTiernan, “if you work in an industry or occupation where you are exposed to radiation or chemicals, be very careful to follow the regulations of your company and the U.S. Occupational Safety and Health Administration.”

Scientists have identified more than 200 potential breast carcinogens. Learn more about them in this broad analysis of existing research from the American Cancer Society.

As a basic rule of thumb, when faced with food, cosmetics, or household products that are loaded with preservatives or other artificial substances, opt when possible for products containing mostly natural ingredients.

Breast cancer experts also advise that you educate yourself about the reality behind all those breast cancer myths out there.

mature-woman-dumbbells
Exercising three to four hours per week at moderate or vigorous levels can reduce your risk of breast cancer by about 20%.
(FOTOLIA)
IF YOU'RE IN YOUR 50s...

As menopause hits, breast cancer rates start to rise, and 1 in 40 women will get the disease in this decade of her life. Taking care of your health becomes more important than ever. Here are the key things you need to do to stay healthy.

1. Schedule an annual mammogram and clinical exam and check your own breasts.
The American Cancer Society recommends that women age 40 and older get a mammogram and a clinical breast exam every year. Also, stay familiar with your own breasts: If you notice any changes, tell your doctor about them immediately.

2. Drink less alcohol.
“This means no more than one drink per day,” says Anne McTiernan, MD, PhD, the director of the Prevention Center at the Fred Hutchinson Cancer Research Center in Seattle and coauthor of Breast Fitness: An Optimal Exercise and Health Plan for Reducing Your Risk of Breast Cancer. “Alcohol use increases your risk for breast cancer.” Sadly, this doesnt mean you can “save up” a weeks worth of drinks for a big Saturday night on the town.

A recent National Cancer Institute study of postmenopausal women found that those who had one to two small drinks a day were 32% more likely to develop the most common type of breast cancer (that with tumors that are positive for both estrogen and progesterone receptors). Women who had three or more drinks daily had as high as a 51% increased risk for hormone-sensitive breast cancer.

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3. Maintain your body weight, or lose weight if you're overweight.
Research has shown that being overweight or obese (especially if you're past menopause) increases your risk, especially if you put on the weight as an adult. And a study released in March 2008 by researchers at the University of Texas M.D. Anderson Cancer Center in Houston showed that obese and overweight women also had lower breast cancer survival rates and a greater chance of more aggressive disease than average weight or underweight women.

Find your healthy weight. A body mass index (BMI) of 25 or less is considered healthy.

4. Eat a healthy diet.
Try to eat 10 servings of fruits and vegetables a day and limit your intake of red meat to 4 ounces (about the size of a deck of cards) per day on average. Dr. McTiernan also recommends avoiding meats such as sausages and bologna. “The chemicals that are used to process the meats have been found to cause several kinds of cancers,” she notes. Strive also to minimize your intake of high-calorie foods such as sugary drinks, juice, desserts, and candies, as well as refined breads and chips.

5. Stay active.
Studies suggest that exercising three to four hours per week at moderate or vigorous levels can reduce your risk of breast cancer by about 20%. “We found in the Womens Health Initiative that there was a benefit to exercising in middle to late years even in women who were inactive when young,” says Dr. McTiernan.

And you dont have to be Dara Torres to reap the benefits: Activities like brisk walking, biking, dancing, or any exercise that raises your heart rate above its baseline level for at least 20 minutes and makes you sweat are beneficial.

6. Avoid (or limit) hormone replacement therapy (HRT).
“Hormone replacement therapy, also known as postmenopausal hormone therapy (PHT), definitely increases your [breast cancer] risk," says Julie R. Gralow, MD, the director of breast medical oncology at the University of Washington and Fred Hutchinson Cancer Research Center in Seattle. “But for women with major menopause issues, Im not opposed to limited courses of HRT—say a five-year period, but not decades.”

7. If youre at high risk of getting breast cancer, ask your doctor whether youre a good candidate for chemoprevention.
“There are two drugs approved for reducing your risk of getting breast cancer: raloxifene, which is approved for use in postmenopausal women, and tamoxifen, which is approved for all ages,” explains Dr. Gralow. “They are very similar. While the average woman should not take a drug to reduce the risk of breast cancer, I would consider them for a woman whos had a biopsy that shows an increased risk for development of cancer.”

MORE TO CONSIDER:

Get enough Vitamin D.
Although the recommended daily allowance of vitamin D is 400 IUs, some researchers think this amount is too low, reports Dr. McTiernan. Researchers from the University of California, San Diego, noting the beneficial effect that vitamin D has been observed to have on breast cancer risk, suggested that higher levels—1,000 IUs of vitamin D a day—may be a convenient and cost-effective way to reduce that risk. (The Institute of Medicine of the National Academies advises that daily intake of vitamin D above 2,000 IU could be dangerous.) Vitamin D occurs naturally in fish and eggs and is commonly found in fortified dairy products. Dr. McTiernan advises that women can get an inexpensive blood test from their doctors to check their vitamin D levels; doctors can recommend supplements as needed.

mature-woman-breast
As you age, your breasts become less dense, and it is easier to perform a breast self-exam (BSE).
(ISTOCKPHOTO)
IF YOU'RE IN YOUR 60s OR OLDER...

The average age of a woman who receives a breast cancer diagnosis is 62, which is why women in their 60s need to be more vigilant than ever about breast health.

1. Continue getting annual mammograms and annual clinical exams.
Screening becomes more important the older you get because your risk keeps going up, says Julie R. Gralow, MD, the director of breast medical oncology at the University of Washington and Fred Hutchinson Cancer Research Center in Seattle. “Fortunately, the older you get, the more fatty your breasts, and the easier it is to read mammograms,” she notes. And while mammograms and clinical exams dont prevent cancer, they can prevent complications from treatment. “If you find it early, you can just get a lumpectomy and you may not need chemo.”

2. Track any changes in your own breasts.
The older you are, the easier it is to do breast self-exams (BSEs), because breasts are less dense, says Dr. Gralow. Here are instructions on how to check your own breasts.

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3. Drink less alcohol.
“This means no more than one drink per day,” says Anne McTiernan, MD, PhD, the director of the Prevention Center at the Fred Hutchinson Cancer Research Center and coauthor, with Dr. Gralow, of Breast Fitness: An Optimal Exercise and Health Plan for Reducing Your Risk of Breast Cancer. “Alcohol use increases your risk for breast cancer.” Sadly, this doesnt mean you can “save up” a weeks worth of drinks for a big Saturday night on the town.

A recent National Cancer Institute study of postmenopausal women found that those who had one to two small drinks a day were 32% more likely to develop the most common type of breast cancer (that with tumors that are positive for both estrogen and progesterone receptors). Women who had three or more drinks daily had as high as a 51% increased risk for hormone-sensitive breast cancer.

4. Exercise regularly.
Studies suggest that exercising three to four hours per week at moderate or vigorous levels can reduce your risk of breast cancer by about 20%. “Its never too late to start,” says Dr. McTiernan. “We found in the Womens Health Initiative that there was a benefit to exercising in middle to late years even in women who were inactive when young.”

And you dont have to be Dara Torres to reap the benefits: Activities like brisk walking, biking, dancing, or any exercise that raises your heart rate above its baseline level for at least 20 minutes and makes you sweat are beneficial.

5. Eat a healthy diet.
Try to eat 10 servings of fruits and vegetables a day and limit your intake of red meat to 4 ounces (about the size of a deck of cards) per day on average. Dr. McTiernan also recommends avoiding meats such as sausages and bologna. “The chemicals that are used to process the meats have been found to cause several kinds of cancers,” she notes. Strive also to minimize your intake of high-calorie foods such as sugary drinks, juice, desserts, and candies, as well as refined breads and chips.

6. Maintain your body weight, or lose weight if you're overweight.
Research has shown that being overweight or obese (especially if you're past menopause) increases your risk, especially if you put on the weight as an adult. And a study released in March 2008 by researchers at the University of Texas M.D. Anderson Cancer Center in Houston showed that obese and overweight women also had lower breast cancer survival rates and a greater chance of more aggressive disease than average-weight or underweight women.

A body mass index (BMI) of 25 or less is considered healthy.

7. Consider chemoprevention to reduce your cancer risk.
Tamoxifen and raloxifene both reduce the chance of developing breast cancer by half for women at increased risk for breast cancer, says Dr. McTiernan—and all women over the age of 60 fall into that category. Talk to your doctor about the benefits and risks of these medications.
Lead writer: Anne Marie O’Connor
Last Updated: September 17, 2008
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